close
close
6 Metro Detroit residents charged in alleged scheme to defraud .75 billion in false Medicare claims

6 Metro Detroit residents charged in alleged scheme to defraud $2.75 billion in false Medicare claims

Criminal charges have been filed against a group of six defendants in alleged schemes to defraud $2.75 billion with false Medicare claims.

The charges were filed in federal court in Detroit on Thursday (June 27) as part of the Justice Department’s Health Care Fraud Enforcement Action 2024.

The charges are part of a two-week, strategically coordinated, nationwide law enforcement effort that resulted in criminal charges against 147 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of more than $2.5 billion in alleged false invoices.

Court documents say the defendants allegedly defrauded programs entrusted to care for the elderly and people with disabilities to line their own pockets, and the government, in connection with the enforcement action, seized more than $150 million in cash, vehicles luxury, gold and other goods.

  • Ibrahim Sammour, 63, and Bashier Sammour, 28, of Wayne County, were charged with conspiracy to pay illegal kickbacks. Ibrahim was additionally charged with conspiracy to commit health care fraud and health care fraud, and Bashier was additionally charged with making false health statements, all in connection with an alleged scheme to obtain over 2 millions of dollars from Medicare fraudulently. According to charging documents, the Sammours operated Individualized Home Health Care, PC, through which they submitted false and fraudulent claims to Medicare for home health care services that were not medically necessary, were not provided as represented, or were not provided.

  • Five others — two registered nurses, two group home owners and a registered nurse — were also charged by the information for their involvement in the conspiracies.

  • Yvette Hardy, 60, of Wayne County, was charged with health care fraud in connection with an alleged scheme to fraudulently obtain more than $3.4 million in Medicare funds. Hardy, who owned and operated Pebble Brook Care Agency LLC, allegedly caused false and fraudulent claims to be submitted to Medicare for psychotherapy services that were not provided as represented or were not provided at all.

  • Ruby Scott, 53, of Oakland County, was charged by indictment with conspiracy to defraud the United States and paying illegal health care kickbacks, as well as paying illegal health care kickbacks in connection with an alleged scheme to fraudulently obtain over $2.2 million in Medicare funds. According to the indictment, Scott, who owned and operated Delta Home Health Care LLC, induced the submission of claims to Medicare for home health care services obtained by paying illegal kickbacks to patient recruiters in violation of the Anti-Kickback Statute.

  • Dr. Vijil Rahulan, 52, of Hyderabad, India, was charged with conspiracy to commit health care fraud and health care fraud in connection with an alleged scheme to obtain more than $82 million in Medicare funds in fraudulently. As alleged in the indictment, Rahulan caused the submission of false and fraudulent claims for DME and genetic testing that were not medically necessary or otherwise ineligible for Medicare reimbursement because they were not the product of a physician- patient. Additionally, the indictment alleges that Rahulan’s fraudulent conduct resulted in Medicare paying more than $28.7 million.

  • Amro Sharafeldin, 40, of Michigan, was charged by criminal complaint with a scheme to violate the Anti-Kickback Statute and illegally purchase Medicare beneficiary information in connection with Sharafeldin’s operation of Prestige Specialty Pharmacy (“Prestige” ) of Sterling Heights, Michigan. As alleged in the complaint, Sharafeldin, through Prestige, agreed to pay bribes and kickbacks to illegally obtain Medicare beneficiary information, which he and others then used in February and March 2023 to bill Medicare more than $1 million for OTC COVID-19 tests, regardless of whether the Medicare beneficiary requested the test kits.